Justin B King MD Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A89447 Issued in CA

Legal business name

JUSTIN B KING MD INC

Practice address

6699 Alvarado Rd Ste 2309
San Diego, CA 92120-5241

Phone

(619) 286-8803

Fax

(619) 286-2344

NPI assigned

Mar 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Justin Benard King, MDNPI 1629262258

Title

President

Phone

(310) 462-8668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin Benard King, MD

  • Surgery Physician
  • National City, CA
  • NPI 1629262258
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1770858573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 880768",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921680768",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD STE 2309",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205241",
            "telephone_number": "619-286-8803",
            "fax_number": "619-286-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN B KING MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "BENARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-462-8668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A89447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.